Exploring the world through the eyes of a chemist

No Such Thing as Low-Hanging Fruit

There is a theory that drug discovery is harder now, that we aren’t getting more and more blockbuster drugs because the easiest targets to make effective drugs for have already been exploited – the so-called low-hanging fruit. And so, as the theory goes, finding new medicines is fraught with failure and disappointment.

John LaMattina tackled this in his latest blog post on Forbes. As a side-note, his blog both before and after moving to Forbes is well worth a read for anyone interested in drug discovery.

His take is that there are countless stories of drug discovery projects going awry and there always have been. In hindsight, it might seem obvious and easy, but when it was going on, plenty of things were hard and did not go as expected. The example of prostaglandins he gave was poignant for me, as even in my undergraduate we were talking about prostaglandins and their importance. Though of course, they were cool little molecules to synthesize as well – I ascribe the A I got in the natural product synthesis class to the synthesis I had of that molecule in my final exam.

My take on the low-hanging fruit issue is not that the easiest things have been found but more that the level of care we can provide now is much higher and so the bar for entry in a particular therapeutic area is correspondingly higher as well. If things had gone differently, it might be that drugs we have today would not make it through clinical trials because of the side effects in comparison to the other drugs we had already. Would acetaminophen make it to market if it was discovered today? Would beta-lactams, a drug series that many people can’t tolerate? Something interesting to ponder.

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One comment on “No Such Thing as Low-Hanging Fruit”

I’m talking about really good drugs — in then early 70s I watched people with Parkinsonism get out of wheelchairs when we gave them L-DOPA. If we had a drug for Alzheimer’s like that it would take about a week for it to be obvious. The difference, is that we had a clear understanding of what was wrong in Parkinsonism — a very small subset of cells in the brain (the dopamine neurons of the substantia nigra probably less than .1% ) were dying. We don’t really have that for cancer, Alzheimer’s, vascular disease, schizophrenia, depression etc. etc.

Your point about incremental improvement is well taken however. Any neuroleptic drug for schizophrenia was so much better than what we had, any antidepressant is better than nothing etc. etc. so it is difficult to improve on that.